Endometriosis FAQ

What happens if endometriosis is left untreated?

If endometriosis is left untreated, the symptoms may get progressively worse and a range of different health complications can occur.1,2 These can cause people’s mental and physical health to be significantly impacted.3,4,5 Complications of untreated endometriosis include, but are not limited to:

  • Chronic pain: endometriosis can cause significant pain specifically in the areas affected, but can sometimes even extend to areas not affected by endometriosis. 
  • Infertility: around 50% of people with endometriosis experience fertility issues, making it one of the most common causes of female infertility.
  • Ovarian cysts: these can cause pain during sexual intercourse, heavy and irregular menstrual cycles, and several other symptoms.
  • Bladder issues: when endometriosis extends to the bladder, it can cause bladder issues, including urinary incontinence.

Fortunately, proper treatment and management of the condition can ease the symptoms and reduce the risk of developing further health complications. The most appropriate type of treatment depends, among other things, on the symptoms, the severity of the condition, and on people’s fertility desires. Discuss the best type of treatment for you with your doctor.

How serious is endometriosis?

Endometriosis can cause symptoms that vary in severity. Some people might experience severe and limiting symptoms, including intense pelvic pain during menstrual cycles or during sexual intercourse, while other people might not observe any noticeable symptoms. Less commonly, people can go on to develop serious health complications, such as bowel obstruction, as a consequence of endometriosis.1,2 Because endometriosis is a common condition that can have a significant impact on people’s health and quality of life, it is important to consult with your doctor if you have any concerns about endometriosis.3,4,5

Can endometriosis come at any age?

Yes. For anyone who has had a menstrual period, endometriosis can come at any age.. However, it most often affects people between the ages of 25 and 40. Importantly, there is an average delay of around 7 to 10 years to be diagnosed with endometriosis.1,2

How do I know I’ve got endometriosis?

Only by consulting with your doctor can you know for certain if you have endometriosis. If you experience any symptoms, there are a range of tests and procedures that your doctor can perform in order to confirm the diagnosis, since endometriosis cannot be definitively diagnosed by symptoms alone. These include pelvic ultrasound, magnetic resonance imaging, and/or laparoscopy

How do you stop endometriosis from progressing?

Hormonal treatment can stop or slow endometriosis progression in addition to potentially alleviating pelvic pain and other symptoms. There are many options for hormonal treatments, including the combined oral contraceptive pill, also commonly known as “the pill”, contraceptive implants, contraceptive injections, progesterone pills, and intrauterine devices. However, any type of hormonal treatment can cause side effects or might be contraindicated for some people.1,2

Is there any treatment for endometriosis?

Yes, there are many available treatments for endometriosis that can significantly reduce its symptoms and improve people’s quality of life. The choice regarding the most suitable course of treatment will take into consideration people’s age, any symptoms, contraceptive preferences, and any other needs or desires a person may have. Treatment options include, but are not limited to, pain relief medication such as nonsteroidal anti-inflammatories, hormonal treatment including combined oral contraceptive pills, contraceptive implants, contraceptive injections, progesterone pills, and intrauterine devices, gonadotropin-releasing hormone (GnRH) analogues, and surgical procedures, such as laparoscopy and hysterectomy.1,2

Is endometriosis caused by stress?

The association between endometriosis and stress is complex and not fully understood yet. Given the available evidence, we cannot state that endometriosis is directly caused by stress. However, there is a clear link between the two. Additionally, endometriosis is associated with an imbalance in the gut microbiome, which has an important role in the metabolism of estrogen, a hormone that leads to endometriosis growth. Still, further research is needed to fully explore the association between stress and endometriosis. 6,7

Who is likely to get endometriosis?

Endometriosis can affect any person who has had a menstrual cycle. However, it occurs more often in people between the ages of 25 and 40 years, people who have a family history of endometriosis, people who experience short menstrual cycles (shorter than 27 days), and people who menstruate for more than seven days.1,2,8

Is endometriosis a life-long condition?

Yes, endometriosis is a long-life condition.1-5 Fortunately, there are many treatments that are effective in easing its symptoms and improving people’s health and quality of life. Additionally, there are many support groups in the United Kingdom and worldwide that provide great support for people affected by endometriosis. 

What stops endometriosis?

Endometriosis growth is associated with the hormone estrogen. That is why hormonal treatments, including the combined oral contraceptive pill, contraceptive implants, contraceptive injections, progesterone pills, and intrauterine devices, can stop or slow endometriosis growth. Hormonal treatment can also ease some of the symptoms of endometriosis.1-5  Therefore, it is important to discuss with your doctor if hormonal treatment is a suitable option for you.

References

  1. Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med 2020; 382:1244-56.
  2. Agarwal SK, Chapron C, Giudice LC, et al. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol 2019(4):354-64.
  3. Nnoaham K, Hummelshoj L, Webster P, et al. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril 2011;96(2):366-73.e8.
  4. Culley L, Law C, Hudson N, Denny E, Mitchell H, Baumgarten M, et al. The social and psychological impact of endometriosis on women's lives: a critical narrative review. Hum Reprod Update. 2013 Nov-Dec;19(6):625-39.
  5. Warzecha D, Szymusik I, Wielgos M, Pietrzak B. The Impact of Endometriosis on the Quality of Life and the Incidence of Depression-A Cohort Study. Int J Environ Res Public Health. 2020 May 21;17(10):3641. 
  6. Reis FM, Coutinho LM, Vannuccini S, Luisi S, Petraglia F. Is Stress a Cause or a Consequence of Endometriosis? Reprod Sci. 2020 Jan;27(1):39-45.
  7. Jiang I, Yong PJ, Allaire C, Bedaiwy MA. Intricate Connections between the Microbiota and Endometriosis. Int J Mol Sci. 2021 May 26;22(11):5644. 
  8. Peterson CM, Johnstone EB, Hammoud AO, Stanford JB, Varner MW, Kennedy A, et al. Risk factors associated with endometriosis: importance of study population for characterizing disease in the ENDO Study. Am J Obstet Gynecol 2013;208:451.e1-451.11.

Juliana Lima Constantino

Medical Doctor and Master Student in Epidemiology, University of Groningen, Netherlands

Juliana completed her studies in Medicine in Brazil in 2019, during which she studied a year abroad in The Netherlands at Vrije Universiteit Amsterdam and took a Medical Elective in England at Oxford University.

After graduating, she worked as a general practitioner and as an emergency doctor in the frontline against COVID-19 in Brazil. In 2021, she moved to the Netherlands to do her Master in Epidemiology.

She is currently working on her Master Thesis in the Global Health Department, with a focus on maternal and child health. She is passionate about medical writing as it serve as a way of spreading trustworthy knowledge to everyone.

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